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Organization
HENRY FORD SEMI MEDICAL GROUP
Active
Organization
HENRY FORD SEMI MEDICAL GROUP
Active
Other names
HENRY FORD SEMI MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CEBALT (DIRECTOR OF PROVIDER AFFAIRS)
(313) 874-6764
Entity
Organization
Contact information
Practice address
21000 E 12 MILE RD, SUITE 102, SAINT CLAIR SHORES, MI 48081-1116
(586) 447-5100
(586) 447-5090
Mailing address
PO BOX 670884, DETROIT, MI 48267-0884
(800) 999-5829
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
207VG0400X
Gynecology Physician
—
NULL
207VG0400X
Gynecology Physician
—
—
207VX0000X
Obstetrics Physician
—
NULL
207VX0000X
Obstetrics Physician
—
—
Other
Enumeration date
11/16/2006
Last updated
04/28/2026
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